Both intrauterine insemination (IUI) and in vitro fertilization (IVF) may be considered in treating couples with subfertility. Although the indications for IUI generally point to a less serious form of subfertility than the indications for IVF, there still appears to be an important overlap between the indications for both treatments. This article discusses the pros and cons in the choice between IUI and IVF based on the available literature. We found three randomized studies and one nonrandomized study in which IVF was compared with IUI with stimulation. In all studies, the pregnancy rate per cycle after IVF was higher than after IUI: with IVF it varied between 18% and 38%, with IUI between 10% and 20%. The number of multiple birth pregnancies was so small that a reliable estimate could not be derived from these studies. If the consideration between IUI and IVF is reduced to a cost effectiveness issue (in terms of costs per fulfilled wish to have children), a first cycle of IUI is generally preferable to a first cycle of IVF (IVF is at least 2.5 times as expensive as IUI, is less burdensome and generates a lower risk of multiple births). The IUI success rate may even decline as far as 11% to keep both treatments equally cost-effective.
|Translated title of the contribution
|Considerations in the choice between intra-uterine insemination and in vitro fertilization as treatment for subfertility
|Number of pages
|Tijdschrift voor Fertiliteitsonderzoek
|Published - 1 Dec 1999